A systematic literature review of the management of chronic venous ulcers with autologous fibrin matrix with or without growth factors

Abstract

Aim: To evaluate available evidence for the effective management of venous leg ulcers with fibrin matrix with or without growth factors.

Methods: A systematic review of the literature was performed to evaluate the use of fibrin matrices with or without growth factors for the management of chronic venous ulcers in lower limbs. Article searches were performed in MEDLINE, EMBASE, COCHRANE, LILACS and ongoing clinical trials at ClinicalTrial.gov.

Results: The search in MEDLINE and EMBASE identified three articles; one was a pilot study evaluating the use of fibrin matrix and autologous growth factors that included patients with chronic ulcers of different etiology. The second article was a description of the product used in the previous study, and the third consisted of a series case reports of patient treated with cultured keratinocytes in a fibrin matrix. A COCHRANE searched resulted in one study assessing the cost effectiveness of using different fibrin matrices. The search in ClinicalTrial.gov and LILACS did not result in any findings.

Conclusion: The study did not provide a conclusive evidence for the use of fibrin matrices in patients with venous leg ulcers.

Keywords

Venous ulcers / legs / fibrin matrix / growth factors

References

[1] Capeheart JK.Chronic venous insufficiency: a focus on prevention of venous ulceration..J Wound Ostomy Continence Nurs1996;23:227-34

[2] Abbade LP,Rollo HeA.Venous ulcer: clinical characteristics and risk factors..Int J Dermatol2011;50:405-11

[3] González-Consuegra RV.Quality of life in people with venous leg ulcers: an integrative review..J Adv Nurs2011;67:926-44

[4] Hume M.Venous ulcers, the vascular surgeon, and the Medicare budget..J Vasc Surg1992;16:671-3

[5] Margolis DJ,Santanna J.Venous leg ulcer: incidence and prevalence in the elderly..J Am Acad Dermatol2002;46:381-6

[6] Phillips T,Provan A.A study of the impact of leg ulcers on quality of life: financial, social, and psychologic implications..J Am Acad Dermatol1994;31:49-53

[7] Ruckley CV.Socioeconomic impact of chronic venous insufficiency and leg ulcers..Angiology1997;48:67-9

[8] Van den Oever R,Debbaut B.Socio-economic impact of chronic venous insufficiency. An underestimated public health problem..Int Angiol1998;17:161-7

[9] O'Connell SM,Hessler K,Carroll RJ.Autologous platelet-rich fibrin matrix as cell therapy in the healing of chronic lower-extremity ulcers..Wound Repair Regen2008;16:749-56

[10] Knighton DR,Fiegel VD,Butler EL.Classification and treatment of chronic nonhealing wounds. Successful treatment with autologous platelet-derived wound healing factors (PDWHF)..Ann Surg1986;204:322-30 PMCID:PMC1251286

[11] Knighton DR,Fiegel VD,Butler E.Stimulation of repair in chronic, nonhealing, cutaneous ulcers using platelet-derived wound healing formula..Surg Gynecol Obstet1990;170:56-60

[12] Celotti F,Negri-Cesi P,Zaninetti R.Effect of platelet-rich plasma on migration and proliferation of SaOS-2 osteoblasts: role of platelet-derived growth factor and transforming growth factor-beta..Wound Repair Regen2006;14:195-202

[13] Cullum N,Fletcher AW.Compression bandages and stockings for venous leg ulcers..Cochrane Database Syst Rev2000;(2):CD000265

[14] O'Connell SM,Dardik H.Cascade^® Autologous system platelet-rich fibrin matrix in the treatment of chronic leg ulcers..Adv Wound Care2012;1:52-5 PMCID:PMC3839008

[15] Hartmann A,Hamm H,Friedl P.Transplantation of autologous keratinocyte suspension in fibrin matrix to chronic venous leg ulcers: improved long-term healing after removal of the fibrin carrier..Dermatol Surg2008;34:922-9

[16] Hankin CS,Lopes M,Maus E.Clinical and cost efficacy of advanced wound care matrices for venous ulcers..J Manag Care Pharmacy2012;18:375-84

[17] O'Donnell TF.A systematic review of randomized controlled trials of wound dressings for chronic venous ulcer..J Vasc Surg2006;44:1118-25

[18] Winter GD.Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig..Nature1962;193:293-4

[19] Cullum N.Leg ulcer treatments: a critical review (Part 2)..Nurs Stand1994;9:32-6

[20] Smith BA.The dressing makes the difference. Trial of two modern dressings on venous ulcers..Prof Nurse1994;9:348, 350-2

[21] Palfreyman SJ,Lochiel R.Dressings for healing venous leg ulcers..Cochrane Database Syst Rev2006;(3):CD001103

[22] Morin RJ.Interactive dressings and topical agents..Clin Plast Surg2007;34:643-58